APAP and heated hose, bloating

I have read a number of threads on this topic but would be grateful for specific advice.
I've been using a machine for 5 years, supplied in Germany: ResMed S8 Autoset. Am now in the UK and it looks as if I will get a Respironics machine and humidifier, but only in April. Meanwhile I've been getting rainout so bought a Hybernite heated hose.

Two things have changed since I saw the hospital: firstly, it turned out that I have never been set on APAP (it was changed to EPR a couple of years ago and I thought that was auto, silly me). Secondly, I got the heated hose. I am now getting bloating, with the heated hose, but more logically it comes from the APAP settings.

I have not used the ResMed software for ages. I may even have deleted it by removing Windows from the old machine (a Mac with VMWare Fusion). Probably I need Sleepyhead and I know there's lots of information on this forum. Would I use Sleepyhead with the USB card reader?

What settings should I change to try to get over the bloating? The sleep study said that 95% of the time my pressure is 12.7, but it can go up to 14. The machine has been set on from 4 to 20. The consultant said there is no point in reducing the 20 because the machine will automatically adjust to what pressure I need.

But is he wrong and should I reduce the maximum pressure to, say, 16?

I have the humidifier on medium setting - III I think. Ought that to go down?

Many thanks for advice.

Zeppa wrote:I have read a number of threads on this topic but would be grateful for specific advice.
I've been using a machine for 5 years, supplied in Germany: ResMed S8 Autoset. Am now in the UK and it looks as if I will get a Respironics machine and humidifier, but only in April. Meanwhile I've been getting rainout so bought a Hybernite heated hose.

Two things have changed since I saw the hospital: firstly, it turned out that I have never been set on APAP (it was changed to EPR a couple of years ago and I thought that was auto, silly me). Secondly, I got the heated hose. I am now getting bloating, with the heated hose, but more logically it comes from the APAP settings.

I have not used the ResMed software for ages. I may even have deleted it by removing Windows from the old machine (a Mac with VMWare Fusion). Probably I need Sleepyhead and I know there's lots of information on this forum. Would I use Sleepyhead with the USB card reader?

What settings should I change to try to get over the bloating? The sleep study said that 95% of the time my pressure is 12.7, but it can go up to 14. The machine has been set on from 4 to 20. The consultant said there is no point in reducing the 20 because the machine will automatically adjust to what pressure I need.

But is he wrong and should I reduce the maximum pressure to, say, 16?

I have the humidifier on medium setting - III I think. Ought that to go down?

Many thanks for advice.

The bloating is called "aerophagia" and you can to to the Search line (above) and put that in and find a gazillion discussions about it.
It's unlikely that the heated hose is the culprit.......more likely the pressure setting.
The "consultant" is likely clueless about this as with his pressure setting advice.
If your minimum pressure is starting at 4 cm. and your 95% pressure is in the neighborhood of 12 - 14, your machine is spending alot of time trying to get from the minimum to those pressures. You didn't mention what your AHI numbers were.

My recommendation would be to gradually increase your minimum pressure and reduce your maximum pressure (try a maximum pressure of around 12 to start with).......because it's probably when your pressures hit the higher levels that your air swallowing (aerophagia) is happening. You need to find the happy medium.......including possibly switching to a fixed pressure.


Den

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Hi - you can leave the high pressure, it's not going to affect anything, but it's the low pressure (4) that needs to go up, at least to maybe 8, and depending on what happens there possibly higher. You can DL SleepyHead software free (good for Macs too!) from Pugsy's first note at the top of the forum. And do a forum search for aerophagia (the bloating stuff).

Having said what I did about the high pressure, I wonder, depending on how things go for ? a week at the new settings, if lowering it after all to a few cm above your usual highest # might help at all with the bloating, but you'd have to try that too, of course, and only try one change at a time so you know what's working and not. I would first raise the low pressure, do the tracking and maybe later the high pressure.

Thanks very much, Wulfman and Julie. Yes, I know it's called aerophagia but as I said, I've seen some threads. Is it not OK to use the word bloating? We all know what it means in this context.

I don't know how many AHIs I have. That's why I said I haven't been using the software lately. I used to have about 4 a night maximum. The machine was set on 14 in recent years, before that on 12.

One thing I wanted to know was if it could go down to 12 because I liked the Swift nasal pillows mask but couldn't use it at 14 pressure. I have now got another Swift but I found I got rainout in the pillows, something I hadn't met before, so am back to the Eson mask at the moment.

As I said, it makes more sense for it to be the pressure than the heated hose causing the aerophagia, it's just that I changed to APAP on December 23rd and had no bloating, and it was only when I used the heated hose, that's been two nights and one afternoon now, that I got it.

So I will get the software set up and do some tracking before I even change the lower setting.

Btw I wrote "consultant" because that's the British term for a specialist doctor at a hospital. Not sure whether you dislike the term or are just implying he doesn't know his stuff. I have seen two consultants privately who were not much use to me - the first wanted to operate but my BMI would have to come down (I don't want to be operated on) and the second said he has 3,000 patients in the NHS at a local hospital and none of them ever heard of rainout. So the current consultant does believe me when I talk about the settings, has no objection to me removing the ramp. I rate that highly, but one is alone with sleep apnoea apart from forums and self-help groups.

Tip - maybe you're already set up properly, but just in case - make sure the machine/humidifier is on a lower level (or at least not higher) than your head - water can't run uphill. I can't comment on the heated hose because I don't use one.

There aren't many "absolutes" in this therapy, so, I suppose it's possible for it to be the heated hose......or something related to that change.

Yes, "bloating" is one of the terms used, but you'll likely find more links to discussions by using "aerophagia".
Can you go back to your previous hose or previous settings to see if it goes away?


Den

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The machine is on the floor and always has been. I intend to put it higher now I have the heated hose. At the moment I haven't got suitable furniture.
When the machine was put on APAP, I got rainout though it wasn't cold. After that I put a hose cover on, the rainout was better but still there, but the temperature was colder.
I'll see how it is tonight. I don't want to go back to fixed pressure. When I did the sleep study I had an S9 on auto and it was pleasanter than mine, and I put this down to the auto setting.
I've looked at a few threads but I will now turn to getting the software working.

It looks as if I can't use Sleepyhead with S8. I will have to see if the ResScan still functions here.